What is the appropriate interval for surveillance imaging of a dilated aortic root?
The short answer is, we don't know. UpToDate recommends annual imaging up to 4.4cm, and then q6 months imaging to 5.4cm. Our AHA/ACC guidelines say we can stretch this out to two years. Nothing in the literature clearly states we can stretch it out further if stable, although clinically, many of us do. I did like this review (attached) from the Cleveland Clinic about imaging thoracic aortic aneurysms generally, and this table specifically:
Table 2. Imaging options for asssessing thoracic aortic aneursym
Wang TKM, Desai MY. Thoracic aortic aneurysm: Optimal surveillance and treatment. Cleveland Clinic Journal of Medicine. 2020;87(9):557-568. doi:https://doi.org/10.3949/ccjm.87a.19140-1
